Sick and Tired: Understanding and Managing Sleep Difficulties in ...

for a period of one week, the study showed that the mindfulness body scan
intervention was feasible to implement in a community setting and participants
receiving the mindfulness body scan intervention displayed greater improvements in
sleep quality and levels of pain in comparison to the PMR control group. This
contrasts with a previous study using sleep quality as an outcome measure, which
found that mindfulness had no effect on sleep quality in people with FMS (Sephton et
al., 2007). The discrepancy in the findings may be explained as the study, completed
as part of this thesis, employed a unique approach, which was feasible for people with
FMS to implement in their own homes, rather than an intensive interventions
delivered by a trained specialist (as applied by Sephton et al., 2007), which may be
difficult for people with FMS to access. The low attrition rates and positive trends in
this feasibility study suggest that a brief mindfulness body scan is a promising
intervention for improving sleep quality and symptoms of pain and fatigue for people
with FMS.
Added Value of the Thesis to the Research Literature
This thesis has helped to clarify the nature of the sleep disturbance experienced in FMS
and has explored some of the factors that may be influencing sleep quality in this
population. By exploring the separate components of sleep quality, these studies have
highlighted the complex nature of the sleep process and how psychological factors may
be involved in the sleep process. For example, some factors such as perceived levels of
stress were found to affect night-time awakenings but not sleep duration in FMS.
The findings of this thesis revealed that the influence of psychological factors on sleep
quality provides support for the integrative model of sleep-interfering and sleep-
interpreting processes proposed for insomnia (Lundh & Broman, 2000). However,
looking specifically at the models proposed for people with chronic pain conditions, the
findings of this thesis suggest that the maintenance of sleep disturbances in FMS is far
more complex than current models suggest. Previous models of sleep and pain have
highlighted the cyclical relationships between fatigue, poor sleep and pain which are
supported by the findings of this thesis for people with FMS. However the links
between coping, sleep and pain remain unclear in people with FMS.
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